This application is in response to RFA-MD-11-002, NIMHD Comprehensive Centers of Excellence (P60). The applicant organization is the Johns Hopkins University, Bloomberg School of Public Health. We seek support to continue the work of the Hopkins Center for Health Disparities Solutions (HCHDS) which was established in 2002 with funding from the NCMHD-EXPORT Center program. We propose to conduct three major research projects. The cross-cutting theme for these projects is exploring health disparities in integrated settings. Our approach is to examine social determinants of health and healthcare disparities by using a novel study design which allows us to examine a verity of important research questions related to health disparities. In addition to our research mission, we propose three community health engagement initiatives, one with a rural community in Talbot County, MD. A second activity is with a community of hospitals who seek to improve disparities in healthcare outcomes. The third is a national activity with churches, universities and community-based organizations. Additionally, we propose to continue our highly successful work in training health professionals to become effective addressing health disparities. The specific aims of the center are: 1) To conduct research that advances knowledge of the biological, behavioral, and socio-environmental etiology of race disparities in health status; 2) To conduct research that advances knowledge of the determinants of race disparities in healthcare access, utilization, and quality of care; 3) To work with community-based partners to raise awareness of health disparities and aid them in their efforts to improve health and health-related outcomes; 4) To enhance the capacity of student and faculty researchers interested in health disparities research; and 5) To serve as a coordinating center and catalyst for the advancement of research and training related to health disparities at Johns Hopkins and elsewhere.